DOW INSTITUTE OF NURSING AND

MIDWIFERY

UNIT XI:

Process of Hospitalization

Misbah khan
Lecture ,DION&M,DUHS
Objectives
At the end of this unit learners will be able to:

1) Define the team admission, transfer and discharge

2) Discuss the procedure for admission, transfer and discharge
3) Identify nursing responsibility during admission, transfer
and discharge
4) Discuss nurse role in preparing patients and family for
discharge
5) Discuss the normal reaction of patient being hospitalized.
Hospitalization
• Hospitalization is admittance to the hospital as a patient.

• Patients are admitted to the hospital for a variety of

reasons, including scheduled tests, procedures, or
surgery; emergency medical treatment; administration
of medication; or to stabilize or monitor an existing
condition.
ADMISSION
 Admission process In Hospital
• Allowing a patient to stay in hospital for observation,
investigation, treatment and care.

• Admission is the entry of a patient into a hospital / ward for

therapeutic / diagnostic purposes
 Types of Admission
1. Emergency Admission: In emergency admission safety and
immediate care of client is essential to save life from emergency
department the client is admitting to special care.

Emergency department Ward , OT ,ICU, CCU, burns unit or

ward

2. Planned admissions: It means that the patients are

admitted for investigations and planned treatment and
surgeries.
 E.g. the patients with hypertension, diabetes, jaundice, hernia, chronic
renal failure.
• OPD admission office ward
Procedure for Admission
• Before the patient is taken to room, admitting
procedures are performed.
1. The patient's personal data is recorded and entered
into the hospital's computer system. This data may
include:
 Patient’s Name
 Patient’s Address
 Date of birth
 Occupation
 Emergency contact information, or the names and
telephone numbers of those individuals the hospital should
contact if the person being admitted needs emergency care
or their condition worsens significantly.
 Insurance coverage
2. Plastic bracelet will be placed on the patient's wrist with :
name, age, date of birth, room number, and medical record
number on it Reason for hospitalization

3. Once all the admitting information has been completed, the next
step is usually being taken to his/her room.
 First of all well come to patient warmly.
 Introduce yourself to the patient and his/her family.
 Review the medical and medication history. May need family present.
 Take height weight of the patient.
 Change hospital gown and trousers (Pajama).
 Ask patient to sit or lie.
 Assess patient take vital sign
 Explain the facility policy on visitors and use of telephone, television,
meal and how to order meal
 Remove and stores all valuable (or send them home)
 Record the admission notes on the patient’s file
4. The nurse will review the doctor's orders, such as what
tests have been scheduled and orient the person to the room.

5. This means that they will explain how to adjust bed height, how
to use the nurse call button, show where the bathroom is located.
Nursing Responsibility During Admission
• Nurses have important responsibilities during the patient
admission process.
• Consent Form
• A critical document obtained during admission.
• Provides legal permission for treatment.
• Ensures the patient understands the procedures and their rights
• Initial Assessment:
– Includes gathering relevant information about the patient's
medical history, current condition, and any presenting
symptoms or complaints.
– perform a physical assessment, checking vital signs.
• Communication and Education:
• Nurses communicate with the patient and their family or
caregivers to obtain additional information, clarify medical
history, explain the admission process, specific procedures,
tests, and treatments, ensuring the patient's understanding
and informed consent.
• Medication Reconciliation
• A crucial step to prevent medication errors.Involves reviewing
and verifying all medications the patient is taking.Ensures safe
and effective medication management during hospitalization.
• Documentation and Record Keeping:
– Nurses accurately document the patient's admission
information, baseline assessment findings, vital signs, and
any notable observations
TRANSFER
 Transfer Process In Hospital
• It is a process to move the patient within the hospital or
hospital to hospital.

• The following are some examples of transferring

– Patient move from Emergency to Hospital ward
– From ICU to General ward
– From one to other room
 Transfer Process In Hospital
• Patient may be transferred within the healthcare facility for
several reasons:
1) Sometimes the transfer is made at the patient's request
a) Type of room (such as a private room)
2) Transfer is made at the medical staff request:
a) The physician may request the patient be transferred from
one level of nursing care to another because of a change
in the patient's condition that might require more or less
specialized care.
b) Sometimes the nursing staff will transfer a patient closer
to the nursing station where the patient's condition can be
supervised more closely.
 Procedure for Transfer
• Check physician order for transfer
• Inform patient and family of the transfer
• Completing a transfer summary.
• Notify the receiving unit of the transfer and when to expect the patient to
transfer
• Gather all the patient’s belongings and necessary care items to
accompany the patient
• Assist in transferring the patient, usually by stretcher or wheel chair
• Make sure that patient is dressed or covered appropriately for
environmental comfort.
• Make sure that all the appropriate patient care measure have been
performed.
– Example: Suctioning of air way, administering prescribed medication, emptying
collection devices
• If oxygen is required, a small transport tank is usually used
• Record condition of patient and means of transfer
• Introduce patient and family to nurses on new unit
– Provide a brief summary of medical diagnosis, treatment care plan and
medications
• Review medical orders with nurse assuming care of the patient
• Complete an intra agency transfer form
• Explain the patient about equipment, policies, and procedures that
are different on the new unit.
• Do patient teaching regarding his/her illness, diet, level of
activity, need for rest, medication, and treatment
• The nurse on new unit will also record an assessment of the
patient’s condition on arrival
DISCHARGE
 Discharge process In Hospital
• Discharge is the termination of care from a health care agency
• Discharge is the official departure of a person from a health
care setting
• When patient leave a hospital after treatment, and go through
a process called hospital discharge.

• It is a systematic process of preparing the patient to leave the

health care settings and maintain the continuing care.
 Types of Discharge
• Planned discharge: Planned discharge is a process of
relieving patients from the hospital after the due completion of
desired treatment of the patient.
• LAMA: Patients may also leave the hospital on its own wish
but against the medical advice which is known as left against
medical advice.
• Parole: In psychotic hospitals who has not been discharge
from the hospital can be sent home for 2-3 days on request of
relatives.
• Absconding: If The patient run away from the ward or
hospital.

The Process of Hospitalization

 Discharge Summary
• A document that provides an overview of the patient's
hospitalization.

• Includes treatments received, outcomes, and

recommendations for follow-up care.
• Essential for the continuity of care after discharge.
 Procedure for Discharge
• Check for doctor order to be discharge
• Check for dues payment
• The nurse should not allow the patient to leave bed unless
discharge slip is over to the patient
• The records should be completed by the doctors and nurses
and all investigation should be attached with discharge slip
• All belonging and left over medicine should be returned to
patient
• Ask patient to bring discharge slip when he comes for
follow up
• Say goodbye with smiling and wish him/her for recovery
Patients Discharge Teaching
• Patient discharge teaching involves providing information and
instructions to patients and their families to ensure a safe and
successful transition from the hospital to home or another care
setting. Discharge teaching includes:
 Medication Instructions
 Self-Care Activities
 Diet and Nutrition
 Activity and Mobility
 Follow-up Care
 Emergency Preparedness
 Written Materials
• Provide written discharge instructions, including medication
schedules, care instructions, and contact information for
healthcare providers.
 Nurse Role In Preparing Patients And
Family For Discharge

• The discharge planning nurse serves as a connection

between in-patient care and follow-up or out-patient care.

• Evidence shows that effective communication is an

essential component of the admission, transfer, and
discharge of patients.

• They help to make sure that the patient and their family
understand exactly what to do after discharge to prevent
injury and encourage healing.
• They are a crucial part of proper patient care.
Normal Reaction of Patient Being Hospitalized

Discomfort and irritability

Strange anxiety
Disruption of routine
Inability to respond actively
Fear of loss of control, dependent and immobility
Irritability and crying
 References
• Suresh.K.sharma ,hospitalization: admission and discharge.
Fundamentals of nursing .potter and Perry's(south Asian
edition